1st Annual Review

[Newtothis]

Had my 1st annual review today; knew my results as I'd phoned for them yesterday.

HbA1c remains at 5.7, Cholesterol 4.7; BP ok; feet ok; kidneys ok; have eye check on the 8th October.

DSN has given me another 3 months to try and lower cholesterol and given me a food plan, so going to see if I can lower it myself, if not am going to consider medication.

I really need to try and inrease my activity but have discomfort in abdoman and scan arranged for October 9th. However, am doing Tai Chi tonight so hope it helps a little.....

1st 12 months have been a rollacoaster...🙄

 

[DeusXM]

Why do you need to lower your cholesterol? The upper limit is 5.0, and you haven't even been given an HDL/LDL/Trig split.

Do let us know what your DSN has suggested as a food plan - would love to see if they're working on the incorrect assumption that dietary cholesterol increases your body cholesterol.

 

[Newtothis]

Why do you need to lower your cholesterol? The upper limit is 5.0, and you haven't even been given an HDL/LDL/Trig split.

Do let us know what your DSN has suggested as a food plan - would love to see if they're working on the incorrect assumption that dietary cholesterol increases your body cholesterol.

Been advised that if I wasn't diabetic then 4.7 would be ok but as I do have diabetes I should aim for 4. DN stated that you can lower cholesterol by diet and gave me a copy of the 'Ultimate Cholesterol Lowering Plan' produced by Heart UK. There are 3 steps, 1) Getting Motivated 2) Building Strong Foundations and 3) Four UCLP Foods to choose from:-

Soya Foods
Foods fortified with Plant Sterols/Stanols
Nuts
Oats and Soluble Fibre

Going to give it 3 months and see if there is any improvements - will let you know xx

 

[Northerner]

Hi Amanda, I think that the foods with plant sterols are supposed to be able to lower your chol by around 10%. I hope you enjoy the Tai Chi, it's something I have enjoyed in the past but don't have any classes near me any more. Exercise is actually one of the best things to improve your good/bad cholesterol split - my consultant says mine is very good largely due to my running, so whatever you can manage will help. Are you still able to swim?

 

[Newtothis]

Hi Amanda, I think that the foods with plant sterols are supposed to be able to lower your chol by around 10%. I hope you enjoy the Tai Chi, it's something I have enjoyed in the past but don't have any classes near me any more. Exercise is actually one of the best things to improve your good/bad cholesterol split - my consultant says mine is very good largely due to my running, so whatever you can manage will help. Are you still able to swim?

Hi Alan, swimming is out at the moment; trying Tai Chi tonight and want to join a yoga class; I need to put a little weight on...:rolleyes. Looing for core strength exercise so suggestions would be welcome.... xx🙂

 

[Northerner]

Hi Alan, swimming is out at the moment; trying Tai Chi tonight and want to join a yoga class; I need to put a little weight on...:rolleyes. Looing for core strength exercise so suggestions would be welcome.... xx🙂

Tai Chi will certainly help - have you done it before or are you new to it?

 

[PattiEvans]

Newtothis
There have been a number of studies which show that the overall mortality rate in women is higher when their cholesterol levels are lower. Cholesterol is a very natural substance needed by the body. I'd be very cautious about trying to lower mine without knowing the lipid breakdown rather than the total chol figure.

I do have a total chol of 5.7 but my HDL is high and trigs are low and I'm very happy with that. Can you ask for a lipid breakdown?

 

[MaryPlain]

Newtothis
There have been a number of studies which show that the overall mortality rate in women is higher when their cholesterol levels are lower. Cholesterol is a very natural substance needed by the body. I'd be very cautious about trying to lower mine without knowing the lipid breakdown rather than the total chol figure.

I do have a total chol of 5.7 but my HDL is high and trigs are low and I'm very happy with that. Can you ask for a lipid breakdown?

Patti please could you post a link to those studies? I'm very interested in this and would like to go armed to my next review as my total cholesterol was a little high last time and the consultant mentioned statins.... I managed to reduce it before but I can't do much in the way of cardio exercise at the moment because of my knees.

 

[cherrypie]

Patti please could you post a link to those studies? I'm very interested in this and would like to go armed to my next review as my total cholesterol was a little high last time and the consultant mentioned statins.... I managed to reduce it before but I can't do much in the way of cardio exercise at the moment because of my knees.

This article explains about women and cholesterol and gives links to the study.

http://www.naturalnews.com/033975_high_cholesterol_heart_attacks.html

 

[mcdonagh47]

This article explains about women and cholesterol and gives links to the study.

http://www.naturalnews.com/033975_high_cholesterol_heart_attacks.html

An interesting article ...

the inverse relationship between Cholesterol and women was found but was not "statistically significant" ie. women with "moderately raised" cholesterol n( Note ; not "HIGH" choleserol" ) have slightly lower mortality rates but it is "something and nothing" and doesn't amount to much and the researchers admit might be a flaw in the Norwegian sample used.

Of course the study doesn't discriminate between diabetics and non-diabetics so these findings are not relevant to any woman on this Support Group. In fact the study specifically excluded anybody with known risk factors for heart disease such as diabetes.

Probably best for female diabetics just to play the percentages and follow the guidelines for cholesterol and diabetes - under 4 TC with specific targets for LDL and HDL. Rather than clutching at straws in studies like this.

 

[everydayupsanddowns]

Ischeamic Heart disease showed a U shape distribution in women with the highest mortality level between 5 and 7 mmol. Moral - if you are a Norwegian woman between the age of 20 and 74 get your TC under 5...

Hang on McD... I think you need to read that abstract again...

Among women, cholesterol had an inverse association with all-cause mortality [hazard ratio (HR): 0.94; 95% confidence interval (CI): 0.89-0.99 per 1.0 mmol L(-1) increase] as well as CVD mortality (HR: 0.97; 95% CI: 0.88-1.07). The association with IHD mortality (HR: 1.07; 95% CI: 0.92-1.24) was not linear but seemed to follow a 'U-shaped' curve, with the highest mortality <5.0 and ≥7.0 mmol L(-1) .

Highest IHD mortality was below 5 and above or equal to 7. So if I was the Norwegian woman you describe I'd increase my risk by aiming for TC under 5

 

[mcdonagh47]

Hang on McD... I think you need to read that abstract again...



Highest IHD mortality was below 5 and above or equal to 7. So if I was the Norwegian woman you describe I'd increase my risk by aiming for TC under 5

Yup, you're probably right on the mathematical symbols.

But when you look at Table 1 in the report the number of deaths for women from Ischaemic Heart Disease at 7 mmol or over is SIX times that of under 5 !

under 5 9 deaths from ISD
5-5.9 19
6.0-6.9 32
7 or over 56 deaths

You would have to do a complicated bit of statistical jiggery-pokery to establish that 56 deaths were lower than 9.

When you look further at the figures for women and Ischaemic heart Disease.you find that there were 7613 women with chols under 5 of which 9 died, giving a death rate of 1 per 828 for chols under 5.
There were 8565 women with chols 5-5.9 and 19 deaths giving a rate of 1 in 450.
There were 6404 in the 6-6.8 range and 32 deaths giving a rate of 1 in 200.
At 7 chols or over there were 5270 women and 56 deaths giving a rate of 1 in 94 deaths from ISD

I'm going to need some convincing that you can manipulate the figures to such an extent to suggest that a death rate of 1 in 94 is better than a death rate of 1 in 828. Even the death rate from ISD in women for chols of 5-5.9 is twice as high (450) as for those under 5 (828).

They are only the figures for deaths from ISD, these figures are not about the full incidence of ISD in relation to chols.

 

[everydayupsanddowns]

You would have to do a complicated bit of statistical jiggery-pokery to establish that 56 deaths were lower than 9.

Not at all. You simply have to compare sample sizes. As you probably know, that's where the 'hazard ratio'* (sometimes called 'risk ratio') figure comes in. It compares nasty outcome with sample size and allows expresses it as a number, so HR of 1 is no change in likelihood, 2 is twice as likely, 0.5 is half as likely.

So for IHD in the table you get:

<5.0..........HR1.00 No change in likelihood of IHD
5.0–5.9......HR0.61 Less likely to have IHD
6.0–6.9......HR0.60 Least likely to have IHD (just!)
7.0............HR0.72 More likely than 5-6.9, but less likely than <5

Noting of course that the HR in the tables is 'adjusted' which I guess is for age/smoking/nonsmoking BP etc, and that the adjustment has a 'confidence interval' of 95% (they are 95% sure this represents the real picture for any individual).

 

[Northerner]

Before we get too carried away with number-crunching, can we bear in mind Amanda's situation - this is after all her thread! She is diet and exercise controlled with excellent control in the non-diabetic range and no history of CVD. If I were in that position then I would feel that aiming for a level of 5 or below, if achieved without medication, would be in the same low-risk category as someone without diabetes, and steering clear of any risks -known or unknown of cholesterol-lowering medications.

 

[everydayupsanddowns]

Good point Alan 🙂 Sorry Amanda!